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Deinstitutionalization? Where have all the people gone?
Lisa Davis1, Anthony Fulginiti, Liat Kriegel
1American Academy of Social Work and Social Welfare School of Social Work University of Southern California, Los Angeles, CA 90089-0411, USA.
Current Psychiatry Reports
|April 25, 2012
Summary
Deinstitutionalization has not improved outcomes for all individuals with serious mental illness (SMI). Those with the greatest need often experience worse community integration and treatment access in the current decentralized system.
Area of Science:
- Psychiatry
- Public Health
- Sociology
Background:
- The deinstitutionalization movement aimed to shift psychiatric care from state hospitals to community settings.
- Concerns persist regarding the well-being and treatment access for individuals with serious mental illness (SMI) post-deinstitutionalization.
Purpose of the Study:
- To examine the outcomes of deinstitutionalization for individuals with SMI.
- To assess current treatment access and community integration for this population.
- To identify disparities in the decentralized mental health care system.
Main Methods:
- Historical overview of the deinstitutionalization movement.
- Analysis of current residence and treatment patterns for individuals with SMI.
- Review of recent trends in treatment access and community integration.
Main Results:
- The decentralized mental health care system has disproportionately benefited individuals with less severe disorders.
- Individuals with serious and persistent mental illness (SMI) often face the most significant challenges.
- Evidence suggests disparities in treatment access and community integration based on illness severity.
Conclusions:
- The current mental health care system's structure may exacerbate challenges for those with SMI.
- Further research is needed to redefine deinstitutionalization's success and address integration barriers.
- Policy and practice adjustments are necessary to ensure equitable care for all individuals with SMI.
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